Department of Hematology and Bone Marrow Transplantation, Rambam Health Care Campus, Haifa, Israel.
Department of Hematology and Bone Marrow Transplantation, Rambam Health Care Campus, Haifa, Israel.
Autoimmun Rev. 2020 Apr;19(4):102493. doi: 10.1016/j.autrev.2020.102493. Epub 2020 Feb 13.
Chronic graft-versus-host disease (cGVHD) remains the main complication of allogeneic hematopoietic stem cell transplantation, limiting its chances for a successful outcome. The over-activity of CD4+ effector T cells and the excessive production of pro-inflammatory cytokines are followed by the development of immune-mediated inflammation and fibrosis of multiple organs. This is the reason for adopting T cell targeting therapies such as cyclosporine A, tacrolimus and mycophenolate mofetil. However, 40% of treated cGVHD patients remain unresponsive, which results in increased morbidity and mortality. Given the complexity of cGVHD pathogenesis, the involvement of B cells as an important player also needs to be explored. Function of aberrant B cells and secretion of relevant cytokines such as B cell activating factor (BAFF) have been found to correlate with cGVHD severity and have therefore become therapeutic targets. Better understanding of the role of B cells and their efficient targeting could improve the outcome of cGVHD.
慢性移植物抗宿主病（cGVHD）仍是异基因造血干细胞移植的主要并发症，限制了其成功的机会。CD4+效应 T 细胞的过度活跃和促炎细胞因子的过度产生导致免疫介导的炎症和多个器官的纤维化。这就是采用 T 细胞靶向治疗（如环孢素 A、他克莫司和霉酚酸酯）的原因。然而，40%的治疗后 cGVHD 患者仍无反应，这导致发病率和死亡率增加。鉴于 cGVHD 发病机制的复杂性，B 细胞作为一个重要参与者的参与也需要探索。异常 B 细胞的功能和相关细胞因子（如 B 细胞激活因子（BAFF））的分泌与 cGVHD 的严重程度相关，因此成为治疗靶点。更好地了解 B 细胞的作用及其有效的靶向作用可以改善 cGVHD 的预后。
